Rehabilitation of injured workers with chronic pain: A stage of change phenomenon

Authors: Yamamoto, S., Unruh, D., & Bullis, M
Year Published 2007
Publication Journal of Occupational Rehabilitation
Volume 17
Number 4
Pages 727-742
Publisher Springer

Work-related injuries incur direct and indirect losses to workers, industry, and society, as well as quality-of-life costs to the injured workers families. Direct costs include wages, disability settlements and pensions, assessment and treatment provided by the health care system,diagnostic examinations, hospitalizations, and surgery. Indirect costs include loss of work productivity from the injured workers, employers, and their families, training of replacement workers, lost tax revenues, and administrative expenses. Quality-of-life costs relate to the losses stemming from the chronic pain experienced by the injured workers and other psychosocial burdens on their families. To minimize these losses, the primary goal of rehabilitation have been to improve work capacity and achieve early return to work (RTW).


This study was designed to explore the stages of change involved in return to work (RTW) for a group of workers who had been suffering from chronic pain.


The setting included Hong Kong Workers Health Center and the Department of Rehabilitation Sciences of The Hong Kong Polytechnic University.


The study sample included 67 injured workers between the ages of 20 and 60.

Data Collection

Assessments of the participants on various measures were conducted before and during the program, and at the end of the follow-up period (3 months post program).


There was no control or comparison condition.


The overall RTW rate of the participants was 65.7%. Most importantly, the participants RTW outcomes were found to be significantly predicted by their readiness for RTW (action) at the baseline. In the third week, their RTW was significantly predicted by their confidence in returning to work and their readiness for RTW (action). By the sixth week, their RTW outcomes were predicted by their readiness for RTW (pre-contemplation).


The results enable us to better understand the stage-of-change factors that might influence injured workers, resumption of a productive work role and the rehabilitation process of RTW.

Populations Male & Female
Outcomes Return to work
Research Design Single group, Observational
Peer Reviewed Yes